Does work cause your IBS?

Is your IBS worse on Monday morning when you go to work?  Does it improve when you take a holiday?   Have you had to take time off work because of it?  Does the pain in your stomach, the discomfort and the bloating affect your concentration, cause you to forget things or make mistakes?  If so, you are not alone?

How does IBS affect work?

IBS predominantly affects the young working population, in particular women who struggle to  balance the responsibilities of work with that of home and family.  IBS is said to cost the UK £800,000 a year in terms of lost productivity, but the real figure is probably much larger.    IBS  causes as much absence from work as colds or flu.  Studies have shown that two days were lost from work per month because of IBS, while another 3 days were curtailed,   people  with IBS missed three times more work than those who did not have it¹.  Other effects on productivity are less easy to estimate.  They include impairment of concentration, loo breaks, tiredness and  performing at below optimum efficiency.   One study from the United States estimated that having IBS doubled the loss of productivity,  reporting that 12-17% patients quit or lost their job because of IBS, 9-18% changed job, 8-9% changed schedule, 15-19% worked fewer hours, 16-26% turned down a promotion, and 11-12% began working from home².  There seems no doubt that IBS  has a big effect on the way you work.

 ‘Constipation is the thief of time; diarrhoea waits for nobody.’

Constipation can make people late for work, whereas diarrhoea can catch people at any time, causing them to have to take frequent loo breaks work, and making travel and meetings almost impossible.  Adequate access to toilets can be a major problem in the workplace and cause considerable embarrassment.  The pain of IBS can make it so difficult to focus on work and also make people reluctant to eat during the working day because it brings on their symptoms.  People are less likely to work efficiently if they are hungry.   Bloating can cause considerable discomfort towards the end of the working day.

It can be almost impossible to integrate work, school, family, and a social life if your gut is also demanding attention,  but often nobody knows.  IBS is a dirty secret.  People cannot tell just by looking at you whether you are just in a bad mood or are struggling to cope with a demon inside that is tying your guts in knots.  And so, without explanation, the time you need for your IBS may lead to frustrations and irritation among work colleagues.

IBS patients report a quality of life that is comparable to patients with clinical depression. And it’s not just IBS.  The findings from a large study, involving more than 125,000 subjects, indicate that patients with IBS are at increased risk for migraine, depression, and fibromyalgia, which is a chronic condition of fatigue, muscle pain, and other symptoms³.

Why does IBS make IBS worse?

Our digestions …. going sacredly and silently right, that is the foundation of all poetry …. the most poetical thing is the world is not being sick. 

                                                                                            G.K. Chesterton.

Digestion and the regulated activities of the gut require time and a relatively unhurried environment.  This encourages the activity of the parasympathetic branch of the autonomic nervous system, which coordinates the emptying of the stomach and the mixing movements of the of the intestines with the stimulation digestive juices and the absorption of nutrients.

Work imposes a conflict on the guts.  The pressures of work, the focussed attention, urgency, deadlines, the ever present threat of failure, the guilt of letting people down, the ambition, the competition, the shame of being found out; all of these stimulate the ‘sympathetic’ nerves, which prepare the body for action,  accelerating the heart rate, raising the blood pressure, increasing concentration, respiration and muscle tone while diverting blood away from gut, inhibiting  digestive secretions, altering intestinal movements causing spasms, pain and bloating and disturbed bowel movements.

While the guts of most people can cope with these pressures without complaint,  it is very different if the gut has been sensitised by an attack of gastroenteritis or life trauma.  Then instead of work being sensed as emotional pressure, the tension is felt in the sensitive gut as another bout of IBS.   All of this is so much worse if you don’t get on with your boss or work colleagues, or if the situation at work reminds you of a situation that may have instigated your IBS in the first place.

What can you do about about it?

At The IBS Network, we do understand that you may not always be able to accommodate your IBS  comfortable in your working day.  Unless you are very fortunate, working life often brings with it a certain amount of stress. There are targets or deadlines, difficult clients, awkward colleagues, a demanding boss and always too many tasks to complete.

Nevertheless, the following lists indicate some changes in your working pattern that you might consider feasible and helpful.

Stress and workload.

• Find a job that you can enjoy and where you feel valued.
• Try to manage your workload. Prioritise tasks.
• Pace yourself. Do what you can in the time available. Try not to be a victim of others’ agendas.
• Take regular breaks away from your desk or work station.
• Don’t keep your IBS a secret. Tell your boss or work colleagues.  Explain how much it upsets you and how although you want to do your best, additional stress will upset your bowels and impair your output.
• Explain that sometimes you may need to leave your desk in a hurry to go to the loo and that you need to be able to eat at regular times.
• Get a note from your GP explaining your condition and how it impacts on your working life.
• Negotiate time at work to better cope with the demands of your IBS. You may need to start later and have a more flexible working pattern.  Home working may be better for your guts.

How to eat and work

• Get up early in the morning so you have plenty of time to have breakfast and go to the loo before you go to work.
• Take a decent lunch break. Leave your work station and go somewhere where you can relax over lunch with friends.
• Bring your own food in. Choose food in amounts you know you can tolerate.
• Don’t be tempted to skip meals to avoid having to go to the loo. It’s much better to keep regular eating patterns if you have IBS.

Access to toilets

• Make sure you have been able to empty your bowels before you leave for work.
• Try to ensure adequate access to a toilet that is clean, private and comfortable, maybe on another floor or in a quiet part of your workplace.
• Allow as much time as you need.
• Consider whether you can work from home.

When it happens

• If you do have an attack of IBS at work, practice deep breathing or relaxation techniques to help you through the cramps and pain.
• If you’ve got to go, you’ve got to go.  Don’t put it off.  It will only get worse.
• Keep a supply of your IBS medication along with some wipes and anything else you might need during an attack, in your desk drawer.

References

1.     Boivin M. Socioeconomic impact of irritable bowel syndrome in Canada. Can J Gastroenterol. 2001;15(2)Suppl B:8-11.

2.      Everhart JE, Renault PF. Irritable bowel syndrome in office-based practice in the Unites States. Gastroenterology. 1991;100:1009-1016.

3.      BMC Gastroenterology, September 28, 2006.